1. Technical Field
The present teaching relates to surgical procedure assistance. More specifically, the present teaching is directed methods, systems, and programing for determining optimal surgical instrument insertion timing in image-guided surgical procedures.
2. Discussion of Technical Background
In image-guided interventional procedures, such as needle biopsy or tumor ablation, interventional radiologists place needles or ablation probes based on images taken of the patient immediately before the procedure. For safety reasons, a needle may not be inserted all at once into the target. Rather a needle may be advanced toward the target step-by-step, and after each needle pass, new images are taken of the patient for verification and/or adjustment of needle position and orientation in order to make the next needle advancement. This process is repeated until the target is reached. This is particular true for lesions located close to critical organs, such as major blood vessels, heart, etc. The imaging modalities used for needle guidance may include, but not limited to, computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound (US).
Interventional radiologists make needle insertion or needle advancement based on images. From the time that the images are taken till the time that the radiologists make needle insertion or needle advancement, there may be many of changes to the patient. First, the patient's breathing status at the time of image acquisition may be different from the time of needle insertion. Patient may have made movements, such as twists. All those may affect the target location change. For example, breathing may cause the lesion to move by more than a centimeter when lesion is close to diaphragm of the lung. It is thus important that at the time of needle insertion or needle advancement, the lesion position be similar to that acquired in images, so that the images provide the closest reality. To find a moment at which the patient condition is mostly close to that at the time of image acquisition is highly desirable.
There have been sensing devices that can detect the breathing status of a patient, e.g., U.S. Patent Application Publication No.: 2009/0099472, Gregor Remmert, Gernot Echner, “Respiratory belt system.” Interventional radiologists may then monitor the breathing status of a patient to pick a moment which resembles closely the breathing status at the time of image acquisition for needle insertion or advancement. However, since such sensing devices are not synchronized with imaging acquisition device, it is difficult to obtain the exact breathing signal corresponding to the image acquisition. Another way of breath handling is to ask the patient to hold breath both for image acquisition and for needle advancement. However many patients may not be able to hold their breath to do image acquisition, due to their health conditions. Therefore, there is a need to provide an improved solution to solve the above-mentioned problems.